Susiani Intan is a Milwaukee, Wisconsin based female Ophthalmologist with 17 years of experience in Ophthalmology. She completed her graduation from Other in 2007. She is also affiliated with hospitals like Aurora St Lukes Medical Center. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Susiani Intan is 62499 in Wisconsin. Susiani Intan is medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, patients can be prescribed vision services, including glasses and contact lenses.
Complete Profile:
Susiani Intan speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Ophthalmology
Credentials:
MD
Experience:
17+ years
Medical School Attended:
Other
Graduation Year:
2007
Gender:
Female
Accepts Medicare Assignment:
Yes
Practice Address:
2801 W Kinnickinnic River Pkwy, Milwaukee, Wisconsin, 53215-3669
Phone:
414-385-1922
Fax:
414-385-1988
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
6709105190
Enrollment ID:
I20211025001227
NPI Number:
1114274529
NPI Enumeration Date:
06 Aug, 2012
NPI Last Update On:
14 Oct, 2024
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Susiani Intan are as mentioned below.
License Number
Specialization
State
Status
62499
Wisconsin
Primary
62449
Psychiatry & Neurology Neurology
Wisconsin
Secondary
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
Hospital Name (CCN)
State
Hospital Type
Aurora St Lukes Medical Center (520138)
Milwaukee, WI
Acute Care Hospital
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which Susiani Intan has association with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Aurora Medical Group, Inc. (6709794258)
2867
Other Medical Identifiers:
Other legacy medical identifiers associated with Susiani Intan such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
100038273
Medicaid
Wisconsin
1114274529
Medicaid
Washington
G8966407
Other
Washington
WVH PTAN
G8966408
Other
Washington
WVH PTAN
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Po Box 735044, Chicago, Illinois
Zip:
60673-5044
Phone Number:
800-326-2250
Fax Number:
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Patients can reach Susiani Intan at 2801 W Kinnickinnic River Pkwy, Milwaukee, Wisconsin or can call to book an appointment on 414-385-1922. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.
Comments/ Reviews:
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